Refugee Open Ware


Innovations within digital manufacturing technologies have led to tremendous advances in the medical device industry and the provision of care for patients worldwide. Continued progress in the field has the potential to provide personalised, high quality solutions that are reliable and for a cheaper cost, making them more accessible for patients everywhere. These solutions have the potential to be especially revolutionary in fragile populations that have been affected by conflict situations and have extremely limited access to health care resources. By the end of 2013, over 50 million people across the world were forcibly displaced. Almost 20% of these cases comprised solely of Syrians, making Syria the largest source country of forcibly displaced persons in the world due to the ongoing Syrian Civil War. An estimated 200,000 Syrians have been seriously disabled by the conflict due to an amputated limb. More than 100,000 of these cases are children, of which 25% are upper limb amputations.

The overwhelming need to introduce and develop innovative practices for the production of upper-body prosthetics was concluded through an initial fact-finding mission into Za’atari, a refugee camp for Syrians fleeing the conflict located in Jordan. The study found that 10 out of 10 of the hospitals, clinics and NGO’s operating in Jordan confirmed the need for a lower cost and more functional prosthesis. Digital fabrication practices have the potential to revolutionise the practice of prosthetic production and address these voiced concerns. However, the same study also showed the high risk of product rejection due to aesthetic reasons, highlighting the need for personalised designs and context-sensitive solutions. In this sense, prosthesis acceptance is the most pressing topic that needs to be addressed, not only to secure successful implementation within the community but also to effectively scale up the project to afflicted users within conflict zones worldwide.

Thusly, this thesis aims to present the research and development towards a new concept for digitally fabricated prosthetics, one that understands and respects the Syrian child refugees’ current situations and perceptions to reduce device abandonment and improve satisfaction rates. The design process presented will demonstrate the possibilities of digitally fabricated prosthetics on user acceptance through investigations ranging from the aesthetics, to technical feasibility and understanding of the cultural context. These investigations consider the user’s perception of the overall form and its ability to improve daily life, materiality to improve performance and mitigate loss of function, and lastly, integrating technology to mediate the user’s behaviour and sensory perceptions of the surrounding environment. At least one site visit will be undertaken to Za’atari to better understand the user by better understanding the built environment, and the local social, cultural and political situations. Additionally, the research will consist of test studies continuously throughout the design process to provide a feedback loop regarding the assessment and development of the design.

Problem Statement

Upper-extremity amputees are estimated to number 650,000 worldwide, representing about ten per cent of amputees. The vast majority of these patients worldwide lack access to both prosthetic devices and to the health care infrastructure required to support them. A particularly neglected subset are the children in developing countries and conflict regions that incur traumatic loss, the most pressing being those casualties of the ongoing Syrian Civil War. These cases have a harder time adjusting than congenital cases as they have experienced the use of a normal limb as well as the anguish of the amputation, including the psychological challenges. They are even more problematic because of the urgent need to fit amputees within 3-6 months of the amputation, often referred to as the ‘golden window’, to ensure a high success rate for limb acceptability. Compounding these difficulties for child amputees is that their limbs are quickly outgrown and costly to replace, resulting in many families without options but to forgo prostheses altogether.

New advancements in technology are already showing signs of a new era of prosthetics. The democratisation of digital fabrication has opened the opportunity for manufacturing customised solutions in less time and for a much cheaper cost. But these solutions are designed with little to no consideration for the user’s preferences. Prosthesis designs are currently designed for congenital cases as toys, in which the child sees the limb as an extension of their body capabilities, rather than designed to help alleviate loss. A practical upper-extremity design must take into account ease of production, fitting for comfortability, and material accessibility within extreme environments. These solutions need to consider the ergonomics of the user’s surrounding to help mediate their experiences within their unique environments. Most importantly, these devices need to provide a tangible benefit for the user, both as a way to contribute to their personal identity and relationships and to help mitigate loss of function.

Parameters for Biomimetic Modeling

.01 Knuckle-to-knuckle Length
Knuckle-to-knuckle Length

.02 Metacarpal Length
Metacarpal Length

.03 Wrist Length
Wrist Length

.04 Minimum Distance between Tensioners
Minimum Distance between Tensioners

.05 Wrist Width
Wrist Width

.06 Wrist Height
Wrist Height

.07 Finger Selection
Finger Selection

.08 Length of the Phalange
Length of the Phalange

.09 Width of the Phalange
Width of the Phalange

.10 Height of the Phalange
Height of the Phalange

.11 Rotational Angle Axis 1
Length of the Phalange

.12 Rotational Angle Axis 2
Length of the Phalange

Lana Awad
Digital Fabrication Applied Research Program
Fab Thesis 2015


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